I quite often listen to Radio 2 as I go about my day to day life, it’s on in the car, the kitchen and even the office, I like the mix of music and chat … this week Chris Evans was discussing some rather interesting stuff that really resonated with me. The section was all about worry and stress and whilst I mostly don’t get too stressed I am a worrier so the conversation was one that I stopped and listened to. Chris and the person he was chatting to (apologies I didn’t catch his name) were talking about how we can cope with stress and worry and the phrase “put your own oxygen mask on before helping others” This was something that I had not heard in this context before and it certainly made me wonder … do we do this in nursing?
Entirely by coincidence last week I ran a series of Twitter Polls through WeNurses asking nurses if they had taken their break that day. I ran it for 3 days … and here are the results:
Whilst the polls themselves reveal some concerning results the comments made in reply to the polls were perhaps the most interesting part:
I’ve never missed a break as a student but I’ve seen lots of nurses miss theirs. Not sure how they can think straight after 12 solid hours!
— katie (@katiel0uise) July 11, 2017
I’m newly qualified. I’ve often gone without a break .. I only do short shifts so not as bad ..
— Sarah Kylie Manning (@RivieraJamming) July 11, 2017
I took 1 half hour break but didn’t get my 2nd break. Made sure my water bottle was at the desk though to stay hydrated
— ✨Debs Cooper✨ (@debscooper131) July 11, 2017
Yes, but staff room was full so ended up eating at my desk…and doing emails!
— Joanne Swidenbank (@jo_swidenbank) July 11, 2017
Not taking a break means that we don’t get to rest, eat or drink. Hydration amongst doctors and nurses on call (El-Shakawry 2016) is a study that looked at the scale and impact of dehydration on doctors and nurses. The study found “Thirty-six percent of participants were dehydrated at the start of the shift and 45% were dehydrated at the end of their shift” and “Single number and five-letter Sternberg short-term memory tests were significantly impaired in dehydrated participants” This doesn’t even take into account hunger or tiredness … and what about the long term effects on mental health and wellbeing and morale? Not taking a break is a serious problem in nursing and you might argue one that affects the care we deliver, yet from the comments not having a break seems so … well … normal … and .. acceptable!
I wonder if we were to view our breaks as oxygen masks would we think differently about the importance of them? I am not being flippant here, I honestly think that we need to take this approach. We have to take care of ourselves before we can take care of others – how can we make important care decisions if we are have not rested, eaten or drunk throughout the course of our shift?
At this point I feel I must confess that I have often been on a clinical shift where I have not taken a break and recently I have been reflecting of why this has happened. Sometimes the shift has been very busy and there just doesn’t seem to have been time for me to step off the floor .. so given the now established fact that breaks are akin to oxygen masks would I do this differently? Yes I think I will – no matter how busy the shift working tired, hungry and thirsty is counter productive and we need to recognise this. If I were on a plane and attended to someone else’s oxygen mask before my own I would soon be on the floor gasping for air and we would both be in trouble ! By taking a break this means I can return to my work refreshed and able to care more effectively.
Although taking breaks whilst on duty takes a change in individual mindset I also think that we have to support colleagues to take breaks to … ask them if they have had a break, do that urgent thing for them whilst they go off the floor, reassure them that you will care for that really unwell person and tell them that in order to care effectively they must take care of themselves. We also need to address organisational culture – is it normal in your work environment that people take breaks? How can we make this a good thing to do? How can we check that people have had a break? How can we support people to take breaks?
The choice is simple – we can either care until we drop, leading to unwell nurses and poor care … or we can take a break and breathe in the oxygen that enables us to provide the very best of care.